“Alarming” Complications in Youth With Type 2 Diabetes

It’s unusual to hear words like “alarming” and “disturbing” in medical research reports, but they were used in a newly released description of the state of health of young people in the United States with type 2 diabetes.

The report was based on data collected from more than 500 diabetes patients in their 20s and younger who were part of a study called Longitudinal Outcomes in Youth with Type 2 Diabetes, or TODAY2. The study began with 699 young people from 10 to 17 who were diagnosed with type 2 diabetes between 2004 and 2011. The research ended in 2011, but the TODAY2 study followed them until the present, at which time they had an average age of 25. Some of them have had diabetes for as many as 12 years, although most have had it for about 7 years. The subjects were diverse — about 40% Hispanic, one-third black, and 20% white; two thirds were female.

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What kinds of health problems were so “alarming”? According to lead investigator Philip S. Zeitler, MD, “Cardiovascular risk factors are highly prevalent…, target organ damage is evident, and serious cardiovascular events are occurring at rates unexpected for age.” Other reported issues were kidney trouble, retinopathy (eye disease) and diabetic neuropathy (nerve damage). Over the years the patients’ blood glucose levels rose, as did their body-mass index (BMI). Five of the subjects died, and one needed triple bypass surgery at age 26. Finally, among the young women who became pregnant, pregnancy complications were “exceptionally high.” The babies tended to show higher rates of respiratory distress, cardiac issues and low birth weight, causing the researchers to make plans to monitor their progress in the future.

According to Dr. Zeitler, the results of the study indicate the need for a change in the usual pediatric approach to diabetes patients, which he described as “Let’s hold off and not give additional medications.” “They have more aggressive disease,” he said, “and they’re going to be living with the burden of cardiovascular disease hopefully for 50 years, so I think the take-home message is we need not hesitate to treat these kids aggressively.”

Want to learn more about diabetes complications? Read “Kidney Disease: Your Seven-Step Plan for Prevention,” “Diabetic Retinopathy” and “Diabetic Neuropathy.”

Joseph Gustaitis

A freelance writer and editor based in the Chicago area, Gustaitis has a degree in journalism from Columbia University.